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Individual

FREDRICK AUNDRAE DURR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
375 SE NE NORTON LANE, SUITE A, MCMINNVILLE, OR 97128
(503) 472-9002
Mailing address
12535 SE KIMSEY RD, DAYTON, OR 97114-8407
(503) 864-2835

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA157429
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA157429
STATE PA LICENSE NUMBER
OR
Enumeration date
06/19/2012
Last updated
05/09/2014
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